I received an email from a doctor having a staff problem. I replied to her and thought this might benefit some other people out there. Please see our discussion below:

Hi Ken,

As an employer, how can you tell your employee to stop his/her: gum smacking, not to laugh at the end of each sentence, to stop blowing her nose as everybody can hear it, to stop asserting herself on someone else’s conversation?

I have such a hard time saying something to my assistant about these issues. Everybody in the office is being affected, and I am not happy at all with her. I try my best to tell her what I would prefer from her as an employee, but it hasn’t worked.

Please help me.

Dr. S

My Reply

Dear Dr. S,

There are several things that can help you in this current situation and help prevent this from happening in the future. This is a bit of a lengthy reply due to the nature of your problem. Please take the time to read through this as I believe it will give you some insight into the problem and how to handle it.

The first, and probably the most important thing is to make sure that you have very detailed job descriptions and office policies in place. In your office policy manual, there needs to be written policies about acceptable and unacceptable employee behavior. When new employees are hired, they are given a copy of this policy manual, and they are to read and sign off on them. This lets them know what is and isn’t permitted in your office. They agree to this, and you now have legal recourse for disciplinary action and/or termination for non-compliance.

As new policies are written, a copy is handed out to all employees for them to read and sign off on. These signed agreements are added to their personnel files. These can then be referenced in regular employee evaluations, disciplinary actions, and if needed, termination situations.

If, however, you only deliver your requests verbally, you leave these requests open to interpretation. It is imperative to have everything in writing so that there is no room for interpretation.

The other underlying issue that I see here is hiring the right people to begin with. There are three steps here:

Attracting the right kind of employees,

Determining who to hire, and

Training them to do their job properly after you’ve hired them.

When you are looking to fill a new position, the wording of your ad/listing is key. Where you are advertising is also a big factor. Utilizing employment agencies that pre-screen applicants to your qualifications can greatly increase the quality of candidates that you see, weeding out the lower quality people ahead of time.Determining who to hire is a shot in the dark for most doctors. They read a resume, conduct an interview and take a shot. No one writes on their resume that they are chronically late, don’t take directions well and can’t get along with others. What you see on a resume is only what the applicant wants you to see. Similarly, all you hear in an interview is what they want you to hear. They say the right things or at the very least what they think that you want to hear in order to get the job.

After they are hired they stay on their best behavior until they get comfortable; then, they become themselves. Only then do you know who you’ve really hired.

You need a more objective way to screen and hire people so that you have a better idea of who they are, what kind of personality they have, their responsibility level, their aptitude and their work ethic. Corporations have been hiring people this way for years. Small businesses suffer through much higher turnover rates due to their lack of successful hiring techniques.

Personality tests, IQ tests, Aptitude tests are all implemented to get a feel for who a person really is and how they will fit into your practice and interact with the staff, more importantly your patients.

Once you have hired the right person, you need to make sure that you train them properly. This is where detailed and up-to-date job descriptions and office policies come into play. It is vital that you equip your new employee with the proper tools to do their job rather than throw them to the wolves and hoping they pick up the proper way to do things as they go.

Here is a policy regarding employee performance evaluations. Take a look at this as I think it will give you an idea of the kinds of policies that should have a place in your office policy manual.

Fill out the form to receive a policy regarding employee performance evaluations(highly recommended).

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It would be nice if employees never made any mistakes and always did a perfect job. But, we are all human, and mistakes and on-the-job errors are part and parcel of running a practice. That raises the question, what do you do when your staff err and how do you correct them? Here are some suggestions on staff correction.

As part of this overall process you must have written job descriptions and office policies that clearly delineate what tasks a person is responsible for on their job and the overall working guidelines for the office. The reason these are so important is that you use them as part of your correction procedure. Unfortunately, very few practice owners have proper job descriptions and office policies in place.

For starters, if you are in need of correcting a staff member, make sure you know of any specific disciplinary policies that you have issued so that your actions are consistent with these. For example, if your policy states that theft is an automatic discharge, you would not work up the disciplinary gradients and only reprimand someone caught stealing.

The first level of addressing correction is normally directing the staff member’s attention to whatever policy he/she violated, what was not done or what should have been done, all of which is delineated in their job description or in your written policies. Have the staff member reread the policy and/or job description. Ensure that they understand it and clear up any confusions or misunderstandings. This is usually enough to handle the first offense.

On the second offense the office manager or practice owner should review the situation with the staff member and have them sign a copy of the policy or procedure that covers what was violated as an attestation that he/she understands and agrees to the policy and/or job description. We then recommend for you to put a copy of the signed document in the personnel folder of the staff member and give a copy to the staff member to put in their staff binder. One can consider that this constitutes a warning.

On the third offense, we recommend that you do the following: give the employee a written warning, a copy of which goes in their personnel file. Sit down and discuss this situation with them; go over the fact that they’ve been corrected on this twice before; and tell them that, per office policy, continual violations could result in a suspension or dismissal.

Practice owners normally find that this type of action on a third offense either puts a stop to the problem or points out clearly that they have a real problem staff member on their hands and that proper actions, including excellent documentation, will need to be taken in order to suspend or dismiss the staff member for future violations.

What do you do with a staff member that you have corrected three times and who messes up again? You’ve already given them a written warning, discussed that continued violations could result in suspension or dismissal, but you still find them doing it again.

At this point you should check their production record (although you should have done that already as part of correcting earlier violations). Hopefully you have a simple statistical method to keep track of key production metrics for each staff member and the office as a whole so that you can monitor their productivity. If the person is an excellent producer (which is unlikely given that they keep messing up), you might consider the next step to be a suspension without pay for a certain number of days. If the person has a poor production record, dismissal may be in order.

Again, the importance of having proper office policies and job descriptions in place in order to properly deal with staff cannot be overemphasized. You can easily put yourself in a legal quagmire if you attempt to discipline staff without these in place.

We also strongly recommend that you check with a good employment attorney when you are looking at dismissing any problem employee to insure that all of your legal bases are covered.

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